Nursing Elites

1. A nurse is caring for a client prescribed montelukast. Which of the following should the nurse include in teaching related to this medication?

• A. Advise the client to take the medication once daily at bedtime
• B. This medication is for the acute management of asthma
• C. Avoid dairy products while taking this medication
• D. If the client forgets to take the medication for a few days, he should not double up on doses to catch up

Correct answer: A

Rationale: The correct answer is to advise the client to take montelukast once daily at bedtime to maintain therapeutic effects. Choice B is incorrect because montelukast is not typically used for acute asthma management but for chronic treatment. Choice C is incorrect as there are no known interactions between montelukast and dairy products. Choice D is incorrect as it is not safe to double up on doses if the client forgets to take the medication; the missed dose should be skipped and the regular dosing schedule maintained.

2. A nurse is caring for a client prescribed methotrexate for rheumatoid arthritis. Which of the following client history findings requires the nurse to question the administration of this medication?

• A. Osteoporosis
• B. Hypertension
• C. Peptic ulcer disease
• D. Immunosuppression

Correct answer: C

Rationale: The correct answer is C: Peptic ulcer disease. Methotrexate can exacerbate peptic ulcer disease, leading to serious complications. This finding warrants questioning the administration of methotrexate to prevent harm to the client. Choices A, B, and D are not directly contraindicated with methotrexate use. Osteoporosis, hypertension, and immunosuppression are not typically reasons to question the administration of methotrexate for rheumatoid arthritis.

3. Before administering blood products, which action should be taken?

• A. Assess the client's temperature
• B. Document client response
• C. Prime IV tubing with 0.45% sodium chloride
• D. Administer epinephrine

Correct answer: A

Rationale: Correct answer: Before administering blood products, the client's temperature must be assessed to establish a baseline and monitor for transfusion reactions. Choice B is incorrect because documenting client response should occur after administering the blood products. Choice C is incorrect as priming IV tubing with 0.45% sodium chloride is not directly related to assessing the client before administering blood products. Choice D is incorrect because administering epinephrine is not a routine action before administering blood products.

4. A nurse is caring for a client prescribed digoxin. Which of the following should alert the nurse to possible digitalis toxicity?

• A. Anorexia and weakness
• B. Hyperactivity and hunger
• C. Tachycardia and increased urination
• D. Polyphagia and polydipsia

Correct answer: A

Rationale: The correct answer is A: Anorexia and weakness. These symptoms are early indicators of potential digitalis toxicity. Anorexia refers to a loss of appetite, which can be a sign of toxicity, and weakness can indicate an issue with digoxin. Choices B, C, and D are incorrect. Hyperactivity and hunger, tachycardia and increased urination, as well as polyphagia and polydipsia are not typically associated with digitalis toxicity.

5. A client is prescribed propranolol. Which of the following client history findings would require the nurse to clarify this medication prescription?

• A. Asthma
• B. Hypertension
• C. Tachydysrhythmias
• D. Urolithiasis

Correct answer: A

Rationale: The correct answer is A: Asthma. Clients with asthma should avoid Beta2 Blockade agents like propranolol as they can lead to bronchoconstriction, potentially worsening asthma symptoms. Choice B, hypertension, is not a contraindication for propranolol; in fact, it is commonly prescribed for hypertension. Choice C, tachydysrhythmias, is often an indication for propranolol due to its antiarrhythmic properties. Choice D, urolithiasis, does not directly impact the use of propranolol.

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